Category Archives: Pain

Fucking Injections

So. I had a ESI injection about 3 weeks ago. I was supposed to have the second injection of the series yesterday, but the claims adjuster for workers comp, in her infinite wisdom, decided I had to have a sit down with my Pain Management doctor first to discuss the after effects of the first injection.

I went in yesterday for my appointment. My doctor asked why we weren’t doing the injection, and I explained the claims adjuster’s reasoning. Man, was my doctor pissed!!! He explained to the nurse case manager that it is a series of injections. Often relief won’t happen after the first, but the second will work, but the injections should be about 2-3 weeks apart. Well, it’s been 3 weeks already, and would be another 2 weeks to get me scheduled and receive approval from wc. So basically that first injection, which incidentally didn’t do dick for my pain, was a waste of my time, my doctor’s time and the insurance company’s money. Siiiiiiiiiigh. Just…fucking sigh. Now we have to go back to square one and start a new series of injections. Fuck me.

I’m schedule for the “first” injection in 2 weeks, and the next injection 2 weeks later. I’m so fucking sick of injections. I mean, compared to spinal fusion, an ESI is like a mosquito bite, but in reality it does fucking hurt. It’s not fun at all, and I’m always miserable for 2-3 days after. And the worst part? They have never helped. The whole ordeal seems pointless for me, not to mention the fact that every time a needle enters my spine there are risks involved. One day I’ll write about my lovely experience with a spinal headache due to a dermal puncture from one of these injections.

If these injections don’t help, it looks like we’ll be moving onto the Spinal Cord Stimulator Implant trial. If it helps, I’ll have one permanently implanted. If it doesn’t help…then I’ll most likely be having that second fusion/discectomy/Laminectomy surgery sooner rather than later.

I’m running out of options here. I don’t even want to start thinking about the possibility that THIS is my permanent situation. If I do, I might just go mad.

On a completely unrelated note, here’s a picture of my cat. Isn’t he precious? I honestly don’t know what I’d do without Malkovich. He’s been so sensitive and in tune with my pain, and he always just seems to know when I need a cuddle.

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Surgery

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Finally, after months of waiting and living with crippling pain, it was time for surgery. I think I spent so long fighting for the approval, and then once it was approved I was so busy getting my house ready and making sure I had everything I needed for my post op care, I hadn’t really focused too much on exactly what I was about to do.

Let me preface this by saying that I had never in my life had surgery of any kind (wisdom teeth don’t count), and I sure picked a hell of a surgery to start with. A fusion at L5-S1 and a discectomy at the same level. The surgeon was about to go into my spine, scrape out a disc, then shave off parts of my vertebrae and pack the shavings into some bone that was taken from a dead body and slip that whole mess in my back, then yank a slipped vertebra back into alignment and finally bolt the whole thing in place with a bunch of metal rods and screws. In the car on the way to the hospital, I started freaking out a bit at the REALITY of all of it.

So. I arrived at the hospital around 5 am. Surgery was scheduled for 7:30. I had my girlfriend and my best friend with me. The girlfriend was for support, and the best friend was to keep the girlfriend from freaking out while I was in surgery. They took me back, had me change into a gown, some compression stockings and some ugly little slipper socks with grippy rubber soles. I also had to put my hair up under one of those hideous paper shower cap looking things. I had been told to arrive sans makeup or lotion, and I had to remove my contacts as well and wear my glasses, so by the time I was changed and prepped, I’m sure I was a sight for sore eyes. Or a sight that CAUSED sore eyes. Whatever.

The nurse started some IV lines. I think I had one in each hand? Maybe? All I know is, I had a lot of tubes coming out of me. Then over the next hour I was visited by three ghosts….no, that’s not right. Oh, yeah, I was visited by three medical professionals: the anesthesiologist, who explained how they would put me under; a nurse who asked me a shit ton of background questions; and finally my surgeon, Dr. Sexy himself. There was a brief discussion about who, exactly, would be seeing my naked ass in the operating room, while I was unconscious and vulnerable, and then I asked him to autograph my back. He grabbed a pen from a passing nurse and, with a grand flourish, marked the surgical site with his initials.

Everything got fuzzy after that. I don’t remember them administering the anesthesia or wheeling me into the OR. The next thing I have any memory of is waking up. I was quite disoriented and confused. I looked around and saw a bunch of monitors and machines, lots of beeping and blinking lights. I looked down at my hands, barely recognizable as hands because they were covered with tubes. Then I tried to move.

Mistake. Big mistake.

Pain exploded! I saw stars. I mean, seriously, I saw STARS. My back felt enormous and it was on fire. My legs felt heavy, like they weren’t even attached to my body. Everything hurt, even my hair follicles, I swear. My very first thought was “What the hell have I gotten myself into?” followed quickly by “What the FUCK did they do to me?!?”

I must have made a sound, because immediately there was a nurse in my face saying my name and asking how I felt. Seriously? Bitch, how do you THINK I felt? I felt like I imagine you would feel upon waking in a strange hotel room, laying in a bathtub full of ice, and missing a damn kidney. I felt like Satan himself had reached into my back and ripped half of my spine out. I felt like I had just run a marathon AND given birth to 12 pound twins AT THE SAME TIME.

The next few hours are kind of blurry. My girlfriend and friend came and went, I drifted in and out of sleep and some chick went buck wild and started throwing chairs across the stage on Jerry Springer. (Daytime tv sucks balls, by the way.) I had come out of surgery around 1:45 pm, but for some reason I wasn’t moved to my recovery room until about 10:30 pm. Once I was wheeled up to my new quarters, I had to transfer myself to the bed. It was the first time I had attempted any movement since first waking up. As if the pain from the surgery weren’t enough, I was connected to a urine catheter (bag o’ pee), a drainage tube in my back near the incision (blood grenade) and an IV. So not only did I have to force myself to push through the pain and actually move my entire body, I had to do it without tangling myself up in any tubes or wires that were coming out of my body in various locations.

It took me about 10 minutes to get into bed. Once I was there, the nurse adjusted the bed and tucked my pillows under my head in an attempt to make me comfortable. Ha. That was a joke. I probably would have felt as equally awful if they had nestled me into the softest cloud or simply rolled my broken ass onto the floor. My nurse brought me a cup of water and ice packs for my back. (Word of advice: if they don’t automatically bring you ice packs, ASK for them. They helped so much.) My girlfriend got my bedside table all set up with the magazines I had brought along, my phone and my tablet, along with the chargers. She wheeled the bedside table as close to me as she could possibly get it and made sure everything was in reach. I also had a huge bag of Jolly Ranchers that I kept near me at all times. My throat was so sore from the tube they had crammed down it, and the hard candies really helped to soothe it.

Once I was settled, the nurse set the alarm on my bed (seriously, if I moved out of the bed, an alarm would sound at the nurses station) and left. My friend hugged me and promised to come back in the morning to visit, then she went to wait in the hall. I was alone with my girlfriend for the first time that day. We were saying our goodbyes (no, she didn’t stay with me; she only had so much time she could take off work because the state does not recognize same sex partnerships so she does not qualify for FMLA to care for me, and I felt it was more important for her to take time off to take care of me once I was home). Now, I must have really looked like shit, because we’ve been together for 7 years, and in that time I’ve seen her cry maybe twice, both times it was about 11 tears tops, but she broke down and SOBBED like a damn baby. I mean, she pulled some full on Scarlett O’Hara shit and threw herself across the bed (ouch!) and bawled. It broke my heart. I could not believe she had held it together all damn day, then lost it when she was leaving. After a few minutes, she straightened up, wiped her eyes, kissed me goodbye, and put on her sunglasses before disappearing down that bright corridor. Such a beautiful, tragic mess.

The rest of that first night was pretty awful. I didn’t sleep at all. My nurse brought me ice packs constantly. I cried A LOT. My pain was, without question, a 10/10. Unfortunately there was nothing that the nurse could do about increasing my meds until the doctors came in around 7 am to do their rounds, so my nurse sat with me all night and held my hand while I sobbed. (I had a Dilaudid pump and I could push the button every 10 minutes, but it turns out they were under dosing me for the first 24 hours or so. This is another story for another post, but suffice it to say when I found out I was pissed and relieved at the same time. Pissed because I had been so miserable and my pain COULD have been alleviated, but relieved because it meant that my pain wasn’t abnormal and I wasn’t just being a big baby who needed to suck it up.)

So there you have it. Surgery. Without a doubt, more painful than 21 hours of hard labor with no epidural and a Pitocin drip (been there). But, at the same time, once it was over and I was in recovery, I knew that I would be able to move on to the next phase: healing.

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10 Weeks Post Op

So. I’ve slacked off with my posting, eh? I had every intention when I started this blog of posting regularly during my recovery. That hasn’t exactly worked out that way, has it? I will attempt to give an accurate account of how I felt at various times during the past 10 weeks by sorting through my Facebook updates, text messages to friends and notes from doctor appointments. I’ll just start here and work my way backwards.

Ten weeks. I can’t believe it’s been that long since I was sliced up. I still feel pretty damn terrible. I’m still using my cane to get around, but I try to make myself not use it around the house as much as possible. I’m still in pain daily, severe pain. In all honesty, it’s worse than it was before surgery. I’m on Fentanyl, Percocet, Lyrica, Cymbalta and a whole bunch of other crap daily. My incision has healed well, though it still itches and burns occasionally, and it’s still lumpy from scar tissue. Once the 28 staples were removed, I started massaging it with vitamin E oil daily, in an attempt to break up the scar tissue. The pain remains in my back, hips and legs, and my physical activity is still very limited. I am tired all the time and feel like I have no energy. I can’t sit longer than 30 minutes without feeling like my back is going to snap in half.

Emotionally, I am broken. I feel like this whole thing was pointless. I am on the verge of just giving up and giving in. I knew going into this that it would be a long recovery, but I am becoming impatient. It feels like I take one step forward and 5 steps back. There are days when I just don’t care anymore, days when I question my decision to undergo such a serious surgery. I also have good days when I can see and feel small improvements. I am definitely stronger than I was 10 weeks ago, yet there are so many things I am unable to do, things that I could do a year ago, even though it hurt. This whole thing has been an emotional roller coaster, so many ups and downs. I know I need to give my body time to heal, but some days it’s just so hard. I want my life back. I question why this happened to me, and cry about the unfairness of it all. I do know that it could always be worse. But right now, it feels like things will never be normal again, yet I refuse to accept this as my new life.

So there it is, and here I am. My next post will talk about the surgery itself, as well as the first few days following surgery. I will talk about the immediate impact surgery had on my day to day life, physical therapy, how I coped with having to ask for help and the toll this has all taken on my family and friends.

Here’s a photo of my incision as it looks today. You can see that they tried to line up my tattoo, but it didn’t exactly work out. I suppose, given the circumstances, they did the best they could. The “hole” above and to the right of the scar is from the drain that I had to have for about a week post op.

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Provocative Discography

Since I don’t have much to talk about right now while I’m just waiting for my surgery, I figured I’ll backtrack and talk about some of the things I’ve been through in the past year and a half. Let’s start with the Provocative Discography. It’s also called a Discogram, and it’s a diagnostic test used to determine the source of pain. As the name suggests, the doctor essentially tries to provoke the pain and the results are based on the patient’s response to what the doctor is doing. I guess it’s not easy to fake, no matter how good of an actor somebody is, because you really have no idea what’s going on. Imagine somebody screaming bloody murder when the doctor isn’t even touching them. I’d say that person could be ruled out as a malingerer, eh?

So, the doctor uses fluoroscopic X-ray to guide a needle into the disc that’s being examined and injects a contrast solution, usually also containing an antibiotic, into the disc. This will show on the X-ray if there are any bulges, tears, leaks and whatnot in the disc. In addition to the visual images, the doctor asks how it feels. If it doesn’t hurt, but just feels pressure like, then the disc is normal and healthy; if it hurts like a motherf*cker, that disc is whack. The doctor will always inject a healthy disc as a “control,” so that they know how you react when they inject a disc that is normal. I guess depending on a person’s pain threshold, someone with a lower tolerance might cry and flip out over just the fact that there’s a needle in their spine, whereas somebody who can handle a lot of pain might not even flinch.

I had a Discography in September 2011, after numerous attempts at conservative treatment had failed to give me any relief, but my pain was increasing and medication was becoming less effective. By conservative treatment, I mean 7 Epidural Steroid Injections, an SI Joint Injection, Facet Joint Injection and a Nerve Ablation, along with 12 weeks of Physical Therapy. My Pain Management doctor wanted to send me for a surgical consultation, but first he wanted to perform the Discography so that I could take the report and the images to the surgeon and show him exactly what was going on.

The nurse took me into the Operating Room, after checking my blood pressure and temperature and having me sign all of the standard release forms, and got me settled on the table, face down. The facility I go to doesn’t require patients to change into gowns or anything, so she just pulled my shirt up to my bra strap, and pulled my jeans down and tucked them under my butt cheeks. She cleaned my back with iodine and laid a paper drape all around the area. That was pretty much the extent of the prep. No IV sedative, no pain killers, nothing.

The doctor came in and cracked a few jokes to lighten the mood. I guess it was pretty obvious that I was really stressed and tense. Keep in mind, I had been through almost a dozen procedures with this doctor, but those were attempts to relieve my pain. At the time, I knew it was going to suck, but I also knew it would be over quickly, and when it was done, there would be a potential for relief from the pain. For this procedure, I knew my doctor would basically be hurting me on purpose. (I think during the procedure I even called him a sadistic bastard and asked him if he likes hurting girls. Luckily, he has a sense of humor and laughed it off.)

Then the doctor started sticking needles into my back. Holy shit. The needles themselves were no big deal at all. I was used to the needles. But when he injected the contrast dye into the bad discs, I was begging for death. The healthy discs were fine, just uncomfortable, especially in comparison to the bad discs. Actually, it was almost a relief when he injected the good discs. I was face down, so I had no clue when he was sticking me or which disc he was planning to hit. When he hit a bad disc and I started crying and yelping, he asked me to describe the pain. I had to tell him what the pain felt like (burning, pressure, sharp), and if it was like my usual pain intensified or at a different location than I was used to experiencing.

The whole process took about 45 minutes, start to finish. He stuck me in every disc from L2 through S1. I had hoped to feel relief once the needles were extracted and the procedure was over, but that fluid was still sitting in my discs, so I felt like I was still undergoing the test. The nurse helped me step down from the table, and my legs felt weak and shaky, which I’m sure was just from the adrenaline rush that was my body’s natural response to the pain. The doctor called me over to show me the images on the monitor screen, the “snapshots” that he had taken during the Discography, while he was torturing me. It was so obvious, even to my uneducated self, where the problem was, and just how severe the degeneration was.

The discs between L3-L4 and L4-L5 were slightly smushed and slightly bulging, but the disc between L5-S1 was practically flat and bulging. It’s like when you pour too much batter in a waffle maker, and it oozes out the side. My “waffle” was flat and oozing and putting pressure on my nerves. The doctor also pointed out a tear in the disc, where the nucleus was leaking out slowly, and that fluid was also contributing to the pain by irritating the nerves.

Then the nurse put me in a wheelchair and took me back to the exam room, where she checked my vital signs again. My blood pressure was really low, so I had to sit and wait for another 15 minutes and have it rechecked. The second time it was a little closer to normal, so she decided I could be released. My doctor came into the room at that point and we had a little chat about the procedure. He told me that I am definitely a candidate for surgery and would be writing a referral for me. He also asked me to come back in a week for another Epidural steroid Injection to kind of calm down the nerve irritation. I was able to walk to the waiting room. My partner was supposed to be picking me off when she got off work, but that was still another 45 minutes away, so I called her, sobbing, and asked if she could come early. It had been a lot worse than I had anticipated, and the lingering pain was intense. I just didn’t think I could sit there for another 45 minutes, and I just wanted to go home, put on my pajamas and curl up in a ball on the couch. She told me to hang in there, made another call, and our neighbor was there to collect me 5 minutes later. Thank Jesus.

After coming home, I spent the next 3-4 days just laying around. I took my painkillers, was very careful with the stairs, and did my stretching exercises. I had had the procedure on Friday afternoon, but I ended up taking the entire next week off work. I felt battered, my back was bruised, and I couldn’t imagine sitting at a desk for 8 hours a day. I went back the following week and had the ESI, which was no big deal at all in comparison to the Discography, and it did somewhat help relieve the nerve pain around the procedure site.

So that’s it. My own personal experience with a Provocative Discography. I’m not going to sugarcoat it – it hurt like a bitch. Was it worth it? Yes. Because after the procedure, the doctor was able to precisely pinpoint the location of my injury and know exactly what was causing my pain. It was very valuable information to take to the surgeons as part of my consultations, so I would definitely go through it again if I had to.

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